What
is a molar pregnancy?
 A
molar pregnancy happens when there
are certain abnormalities in the fertilized
egg at conception. The fertilized
egg either never develops into an
embryo (this is called a complete
mole) or it develops abnormally and
can't survive (this is a partial mole).
In
normal pregnancies, the fertilized
egg contains 23 chromosomes from the
father and 23 from the mother. In
most complete molar pregnancies, the
fertilized egg contributes no maternal
chromosomes and the chromosomes from
the father's sperm are duplicated,
so you end up with two copies of chromosomes
from the father and none from the
mother. In this case, there's no embryo,
amniotic sac, or any normal placental
tissue. Instead, the placenta forms
a mass of cysts that looks like a
cluster of grapes.
In
most partial molar pregnancies, the
fertilized egg has the normal complement
of chromosomes from the mother but
double the chromosomes from the father,
so there are 69 chromosomes instead
of the normal 46. (That can happen
when chromosomes from the sperm are
duplicated or when two sperm fertilize
the same egg.) In this case, there's
some normal placental tissue among
the cluster-like mass of abnormal
tissue. The embryo does begin to develop,
so there may be a fetus, or just some
fetal tissue, or an amniotic sac.
But even if a fetus is present, in
most cases it's so abnormal that it
can't survive.
It
can be scary and sad to lose a pregnancy
this way. But as long as you get proper
treatment, you're unlikely to have
any long-term physical consequences.
What
are the symptoms of a molar pregnancy?
A molar pregnancy may start off like
a normal pregnancy. Then, around the
10th week of pregnancy, vaginal bleeding,
which often is dark brown in color,
usually occurs. Other common symptoms
include: severe nausea and vomiting,
abdominal cramps (from a uterus that
is too large due to the increasing
number of cysts), and high blood pressure.
How
is a molar pregnancy diagnosed?
An ultrasound examination can diagnose
a molar pregnancy. The doctor also
will measure the levels of hCG, which
often are higher than normal with
a complete mole, and lower than normal
with a partial mole.
How
is a molar pregnancy treated?
A molar pregnancy is a very frightening
experience. Not only does the woman
lose a pregnancy, she learns that
she has a slight risk of developing
cancer. In order to protect the woman,
all molar tissue must be removed from
the uterus. This usually is done using
a procedure called suction curettage,
under general anesthesia. Occasionally,
when the mole is extensive and the
woman has decided against future pregnancies,
a hysterectomy may be done.
After
the procedure, the doctor will again
measure the level of hCG. If it has
dropped to zero, the woman generally
needs no additional treatment. However,
the doctor will continue to monitor
hCG levels for one year to be sure
there is no remaining molar tissue.
A woman who has had a molar pregnancy
should not become pregnant for one
year, because a pregnancy would make
it difficult to monitor hCG levels.
What
is the outlook for future pregnancies
after a molar pregnancy?
If a woman has a molar pregnancy,
her outlook for a future pregnancy
is good. The risk that a mole will
develop in a future pregnancy is only
one to two percent.
Both
ectopic and molar pregnancies are
medical emergencies. As she undergoes
diagnosis and treatment, the pregnant
woman may be concerned mainly about
her own health. Afterwards, the woman
and her partner feel relief that she
has come through the ordeal. Then
grief over the loss of the pregnancy
may hit them. As with any couple who
has lost a pregnancy, they need time
to grieve and to recover emotionally.
This is a difficult time, and it may
be helpful for the couple to speak
with a counselor who is experienced
in dealing with pregnancy loss.
More
to come on Molar Pregnancy...
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